Stopcock

ABSTRACT

According to a preferred embodiment of the present invention there is provided a stopcock including a housing element defining at least first, second and third ports, a handle element which is selectably positionable relative to the housing element, at least one fluid passageway communicating between at least two of the at least first, second and third ports, the at least one fluid passageway being selectably defined by at least one of the housing element and the handle element, the at least one fluid passageway being configured for enabling flushing an internal volume of at least one of the first, second and third ports by a fluid flow which does not flow entirely through the port whose internal volume is being flushed.

REFERENCE TO RELATED APPLICATIONS

This application is a divisional application of U.S. patent applicationSer. No. 13/167,871, filed Jun. 24,2011, entitled “STOPCOCK”, which is acontinuation of U.S. patent application Ser. No. 11/574,618, now U.S.Pat. No. 7,984,730, filed Apr. 20,2007, entitled “STOPCOCK”, which is aNational Phase Application of PCT/IL2005/000925, filed Aug. 29, 2005,entitled “STOPCOCK”, which claims priority of U.S. Provisional PatentApplication No. 60/607,113, filed Sep. 2, 2004, entitled “CLOSEDSTOPCOCK” and U.S. Provisional Patent Application No. 60/641,909, filedJan. 5, 2005, entitled “CLOSED STOPCOCK FOR ARTERIAL MONITORING”, thedisclosures of all of which are hereby incorporated by reference.

FIELD OF THE INVENTION

The present invention relates to stopcocks generally, and morespecifically to swabbable stopcocks.

BACKGROUND OF THE INVENTION

The following publications are believed to represent the current stateof the art: U.S. Pat. Nos. 5,549,651, RE 37,357 and 6,238,372 and U.S.Patent application 2004/0210162.

SUMMARY OF THE INVENTION

The present invention seeks to provide an improved swabbable stopcockdevice.

There is thus provided in accordance with a preferred embodiment of thepresent invention a stopcock including a housing element defining atleast first, second and third ports, a handle element which isselectably positionable relative to the housing element, at least onefluid passageway communicating between at least two of the at leastfirst, second and third ports, the at least one fluid passageway beingselectably defined by at least one of the housing element and the handleelement, the at least one fluid passageway being configured for enablingflushing an internal volume of at least one of the first, second andthird ports by a fluid flow which does not flow entirely through theport whose internal volume is being flushed.

Preferably, the handle element and the housing element are arrangeablein multiple mutual positions wherein the at least one fluid passagewayis configured for enabling flushing the internal volume of at least oneof the first, second and third ports when the housing element and thehandle element are in at least one of the multiple mutual positions.

Preferably, the stopcock also includes at least one valve, which isassociated with at least one of the first, second and third ports.Additionally, the valve includes an elastomeric element and the at leastone fluid passageway is configured for providing a fluid flow which issealed from the elastomeric element when the housing element and thehandle are in another one of the mutual positions.

Additionally, the at least one fluid passageway is defined by a shaftportion of the handle element.

Preferably, the stopcock also includes a fluid flow guide associatedwith the at least one fluid passageway for enabling flushing of theinternal volume of the at least one of the first, second and third portswhen the housing element and the handle element are in the at least oneof the mutual positions by the fluid flow which does not flow entirelythrough the port whose internal volume is being flushed.

Preferably, the at least one fluid passageway is defined by at least onerecess formed on a peripheral surface of the handle element.Alternatively, the at least one fluid passageway is defined by at leastone bore formed within the shaft portion of the handle element.Additionally or alternatively, the fluid flow guide extends radially andpartially bifurcates the at least one fluid passageway.

Preferably, the fluid flow guide includes a concave outward facing edge.Alternatively, the fluid flow guide includes an outward facing edgeadapted to prevent flow of liquid when the fluid flow guide is notlocated opposite at least one of the ports. Additionally, at least oneof the at least one port is bifurcated by the fluid flow guide.

Preferably, the housing element includes a side recess located within acentral bore of the housing element.

There is also provided in accordance with another preferred embodimentof the present invention an arterial monitoring set including anarterial line adapted to be connected at a first end thereof to a sourceof liquid under pressure and at a second end thereof to an artery of apatient, a pressure transducer disposed along the arterial line forsensing liquid pressure therein, a stopcock disposed along the arterialline, the stopcock including a housing element defining at least first,second and third ports, a handle element which is selectablypositionable relative to the housing element, at least one fluidpassageway communicating between at least two of the at least first,second and third ports, the at least one fluid passageway beingselectably defined by at least one of the housing element and the handleelement, the at least one fluid passageway being configured for enablingflushing an internal volume of at least one of the first, second andthird ports by a fluid flow which flows through the arterial line to thepatient.

Preferably, the handle element and the housing element are arrangeablein multiple mutual positions and the at least one fluid passageway isconfigured for enabling flushing the internal volume of at least one ofthe first, second and third ports when the housing element and thehandle element are in at least one of the multiple mutual positions.

Preferably, the stopcock includes at least one valve, which isassociated with at least one of the first, second and third ports.Additionally, the valve includes an elastomeric element and the at leastone fluid passageway is configured for providing a fluid flow which issealed from the elastomeric element when the housing element and thehandle are in another one of the mutual positions.

Preferably, the at least one fluid passageway is defined by a shaftportion of the handle element.

Additionally, the arterial monitoring set also includes a fluid flowguide associated with the at least one fluid passageway for enablingflushing of the internal volume of at least one of the first, second andthird ports when the housing element and the handle element are in atleast one of the mutual positions by the fluid flow which flows throughthe arterial line to the patient.

Preferably, the at least one fluid passageway is defined by at least onerecess formed on a peripheral surface of the handle element.Alternatively, the at least one fluid passageway is defined by at leastone bore formed within the shaft portion of the handle element.Additionally or alternatively, the fluid flow guide extends radially andpartially bifurcates the at least one fluid passageway.

Preferably, the fluid flow guide includes a concave outward facing edge.Alternatively, the fluid flow guide includes an outward facing edge toprevent flow of liquid when the fluid flow guide is not located oppositeat least one of the ports.

Preferably, at least one of the at least one port is bifurcated by thefluid flow guide. Alternatively or additionally, the housing elementincludes a side recess located within a central bore of the housingelement.

There is further provided in accordance with yet another preferredembodiment of the present invention a method of providing fluidcommunication with the circulatory system of a patient includingproviding a stopcock including a housing element defining at leastfirst, second and third ports, a handle element which is selectablypositionable relative to the housing element, at least one fluidpassageway communicating between at least two of the at least first,second and third ports, the at least one fluid passageway beingselectably defined by at least one of the housing element and the handleelement, providing a flow of a first fluid through the stopcock incommunication with the circulatory system of the patient when the handleelement and the housing element are in a first mutual position, andproviding a flow of a second fluid through the stopcock in communicationwith the circulatory system of the patient when the handle element andthe housing element are in a second mutual position, thereby flushing aninternal volume of at least one of the first, second and third ports bythe second fluid which does not flow entirely through the port whoseinternal volume is being flushed.

Preferably, the flow of the first fluid passes through the stopcock fromthe second port to the third port and the flow of the second fluidpasses through the stopcock from the first port to the third port.Alternatively, the flow of the first fluid passes through the stopcockfrom the third port to the second port and the flow of the second fluidpasses through the stopcock from the third port to the first port.

Preferably, the stopcock also includes at least one valve, which isassociated with at least one of the first, second and third ports.Additionally, the valve includes an elastomeric element and the at leastone fluid passageway is configured for providing a fluid flow which issealed from the elastomeric element when the housing element and thehandle are in a third mutual position.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be understood and appreciated more fully fromthe following detailed description, taken in conjunction with thedrawings in which:

FIG. 1 is a simplified exploded view illustration of a stopcockconstructed and operative in accordance with a preferred embodiment ofthe present invention;

FIGS. 2 and 3 are simplified pictorial illustrations of a housingelement, and a threaded plug, which form part of the stopcock of FIG. 1taken in two different directions;

FIGS. 4A and 4B are sectional illustrations taken along section linesIVA-IVA and IVB-IVB in FIGS. 2 and 3, respectively;

FIGS. 5A and 5B are simplified pictorial illustrations of a handleelement which forms part of the stopcock of FIG. 1 in two orientations;

FIGS. 6A and 6B are simplified plan view illustrations of the handleelement of FIGS. 5A and 5B taken along respective directions A and J3 inFIG. 5A;

FIGS. 7, 8A and 8B are sectional illustrations taken along section linesVII-VII, VIIIA-VIIIA and VIIIB-VIIIB in FIG. 5B;

FIGS. 9A, 9B, 9C, 9D and 9E are simplified pictorial illustrations ofthe stopcock of FIG. 1 in five operative orientations;

FIGS. 10A, 10B, 10C, 10D and 10E are sectional illustrations taken alongsection lines XA-XA, XB-XB, XC-XC, XD-XD and XE-XE in FIGS. 9A, 9B, 9C,9D and 9E respectively;

FIG. 11 is a simplified exploded view illustration of a stopcockconstructed and operative in accordance with another preferredembodiment of the present invention;

FIGS. 12 and 13 are simplified pictorial illustrations of a housingelement, which fowls part of the stopcock of FIG. 11 taken in twodifferent directions;

FIGS. 14A and 14B are sectional illustrations taken along section linesXIVA-XIVA and XIVB-XIVB in FIGS. 12 and 13, respectively;

FIGS. 15A and 15Bare simplified pictorial illustrations of a handleelement which forms part of the stopcock of FIG. 11 in two orientations;

FIGS. 16A and 16B are simplified plan view illustrations of the handleelement of FIGS. 15A and 15B taken along respective directions A and Bin FIG. 15A;

FIGS. 17, 18A and 18B are sectional illustrations taken along sectionlines XVII-XVII, XVIIIA-XVIIIA and XVIIIB-XVIIIB in FIG. 15B;

FIGS. 19A, 19B, 19C and 19D are simplified pictorial illustrations ofthe stopcock of FIG. 11 in four operative orientations;

FIGS. 20A, 20B, 20C and 20D are sectional illustrations taken alongsection lines XXA-XXA, XXB-XXB, XXC-XXC and XXD-XXD in FIGS. 19A, 19B,19C and 19D respectively;

FIG. 21 is a simplified exploded view illustration of a stopcockconstructed and operative in accordance with an additional preferredembodiment of the present invention;

FIGS. 22 and 23 are simplified pictorial illustrations of a housingelement, which forms part of the stopcock of FIG. 21 taken in twodifferent directions;

FIGS. 24A and 24B are sectional illustrations taken along section linesXXIVA-XXIVA and XXIVB-XXIVB in FIGS. 22 and 23, respectively;

FIGS. 25A and 25B are simplified pictorial illustrations of a handleelement which forms part of the stopcock of FIG. 21 in two orientations;

FIGS. 26A and 26B are simplified plan view illustrations of the handleelement of FIGS. 25A and 25B taken along respective directions A and Bin FIG. 25A;

FIGS. 27, 28A and 28B are sectional illustrations taken along sectionlines XXVII-XXVII, XXVIIIA-XXVIIIA and XXVIIIB-XXVIIIB in FIG. 25B;

FIGS. 29A, 29B, 29C and 29D are simplified pictorial illustrations ofthe stopcock of FIG. 21 in four operative orientations;

FIGS. 30A, 30B, 30C and 30D are sectional illustrations taken alongsection lines XXXA-XXXA, XXXB-XXXB, XXXC-XXXC and XXXD-XXXD in FIGS.29A, 29B, 29C and 29D respectively;

FIG. 31 is a simplified exploded view illustration of a stopcockconstructed and operative in accordance with a further preferredembodiment of the present invention;

FIGS. 32 and 33 are simplified pictorial illustrations of a housingelement, which forms part of the stopcock of FIG. 31 taken in twodifferent directions;

FIGS. 34A and 34B are sectional illustrations taken along section linesXXXIVA-XXXIVA and XXXIVB-XXXIVB in FIGS. 32 and 33, respectively;

FIGS. 35A and 35B are simplified pictorial illustrations of a handleelement which forms part of the stopcock of FIG. 31 in two orientations;

FIGS. 36A and 36B are simplified plan view illustrations of the handleelement of FIGS. 35A and 35B taken along respective directions A and Bin FIG. 35A;

FIGS. 37, 38A and 38B are sectional illustrations taken along sectionlines XXXVII-XXXVII, XXXVIIIA-XXXVIIIA and XXXVIIIB-XXXVIIIB in FIG.35B;

FIGS. 39A, 39B, 39C and 39D are simplified pictorial illustrations ofthe stopcock of FIG. 31 in four operative orientations;

FIGS. 40A, 40B, 40C and 40D are sectional illustrations taken alongsection lines XLA-XLA, XLB-XLB, XLC-XLC and XLD-XLD in FIGS. 39A, 39B,39C and 39D respectively;

FIG. 41 is a simplified exploded view illustration of a stopcockconstructed and operative in accordance with yet another preferredembodiment of the present invention;

FIGS. 42 and 43 are simplified pictorial illustrations of a housingelement, which forms part of the stopcock of FIG. 41 taken in twodifferent directions;

FIGS. 44A and 44B are sectional illustrations taken along section linesXLIVA-XLIVA and XLIVB-XLIVB in FIGS. 42 and 43, respectively;

FIGS. 45A and 45B are simplified pictorial illustrations of a handleelement which forms part of the stopcock of FIG. 41 in two operativeorientations;

FIGS. 46A and 46B are simplified plan view illustrations of the handleelement of FIGS. 45A and 45B taken along respective directions A and Bin FIG. 45A;

FIGS. 47, 48A and 48B are sectional illustrations taken along sectionlines XLVII-XLVII, XLVIIIA-XLVIIIA and XLVIIIB-XLVIIIB in FIG. 45B;

FIGS. 49A, 49B, 49C and 49D are simplified pictorial illustrations ofthe stopcock of FIG. 41 in four operative orientations;

FIGS. 50A, 50B, 50C and 50D are sectional illustrations taken alongsection lines LA-LA, LB-LB, LC-LC and LD-LD in FIGS. 49A, 49B, 49C and49D respectively;

FIG. 51 is a simplified exploded view illustration of a stopcockconstructed and operative in accordance with a further preferredembodiment of the present invention;

FIGS. 52 and 53 are simplified pictorial illustrations of a housingelement, which forms part of the stopcock of FIG. 51 taken in twodifferent directions;

FIGS. 54A and 54B are sectional illustrations taken along section linesLIVA-LIVA and LIVB-LIVB in FIG. 53;

FIGS. 55A and 55B are simplified pictorial illustrations of a handleelement which forms part of the stopcock of FIG. 51 in two operativeorientations;

FIGS. 56A and 56B are simplified plan view illustrations of the handleelement of FIGS. 55A and 55B taken along respective directions A and Bin FIG. 55A;

FIGS. 57, 58A and 58B are sectional illustrations taken along sectionlines LVII-LVII, LVIIIA-LVIIIA and LVIIIB-LVIIIB in FIG. 55B;

FIGS. 59A, 59B, 59C and 59D are simplified pictorial illustrations ofthe stopcock of FIG. 51 in four operative orientations;

FIGS. 60A, 60B, 60C and 60D are sectional illustrations taken alongsection lines LXA-LXA, LXB-LXB, LXC-LXC and LXD-LXD in FIGS. 59A, 59B,59C and 59D respectively; and

FIGS. 61A, 61B and 61C are simplified pictorial illustrations of anarterial monitoring set constructed and operative in accordance with apreferred embodiment of the present invention in various operativeorientations.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Reference is now made to FIG. 1, which is an exploded view illustrationof a stopcock, constructed and operative in accordance with a preferredembodiment of the present invention. As seen in FIG. 1, the stopcockcomprises a housing element 10 including a main tubular portion 12 andthree side ports, designated by reference numerals 14, 16 and 18respectively. A handle element 20 is arranged to be seated within maintubular portion 12 of housing element 10. A typical threaded plug 23 isadapted to be connected to side port 16.

Reference is now made additionally to FIGS. 2 and 3 which are pictorialillustrations of housing element 10 and to FIGS. 4A and 4B which aresectional illustrations thereof. As seen in FIGS. 1-4B, tubular portion12 of housing element 10 is generally cylindrical, arranged about anaxis 22, and has side ports 14, 16 and 18 extending in differentdirections therefrom, typically separated by 90 degrees about axis 22.Port 14 is preferably a male port which preferably meets luer standardISO 594-1, while ports 16 and 18 are preferably female ports, whichpreferably meet luer standard ISO 594-1. Conventional plugs, nuts andcovers may be used in association with ports 14, 16 and 18. As seenparticularly in FIGS. 1-3, threaded plug 23 is shown arranged forsealing engagement with port 16. Tubular portion 12 includes a centralbore 24 having a slightly conical configuration, which is formed with acircumferential undercut 26. Port 16 defines an internal volume 25.

Reference is now made to FIGS. 5A-8B, which illustrate handle element20. As seen in FIGS. 5A-8B, the handle element includes a shaft portion30, which is integrally formed with a top portion 32 from which extendsa finger-engageable protrusion 34. It is appreciated that any othersuitable general configuration of the top portion of the handle elementmay alternatively be employed.

Shaft portion 30 is generally symmetrical about a shaft axis 42 and hasa slightly conical outer surface 44, typically having an angle a (asseen particularly in FIG. 6A) of 3-4 degrees, which corresponds to theslightly conical configuration of central bore 24 for rotatable sealingengagement therewith. As seen particularly in FIGS. 8A and 8B, shaftportion 30 is typically formed with mutually sealed top and bottomcylindrical recesses 46 and 48, which are sealingly separated by adivider 50.

Disposed generally between recesses 46 and 48 and sealed therefrom is apartially peripherally-extending recess 52, selectably defining a fluidflow passageway between selectable ones of side ports 14, 16 and 18depending on the rotational orientation of the handle element 20relative to the housing element 10. Preferably extending radially andpartially bifurcating the recess 52 is a fluid flow guide 54, whichdirects the flow of liquid between ports 14 and 18 through thepassageway defined by recess 52 into the internal volume 25 of port 16for flushing thereof, when the handle element 20 is suitably positioned.The radially outward facing edge 56 of fluid flow guide 54 is formedwith a concave configuration.

Reference is now made to FIGS. 9A, 9B, 9C, 9D and 9E, which aresimplified pictorial illustrations of the stopcock of FIG. 1 in fiveoperative orientations and to FIGS. 10A, 10B, 10C, 10D and 10E, whichare sectional illustrations of the stopcock of FIGS. 9A, 9B, 9C, 9D and9E respectively.

FIGS. 9A and 10A illustrate a first operating position of the stopcockof FIG. 1 when port 16 is sealed as by threaded plug 23. The usertypically connects a source of pressurized fluid, such as an IV set, toport 18 and the liquid flows through port 18 and partiallyperipherally-extending recess 52 and past the concave edge 56 of fluidflow guide 54 via port 14 to the patient, as indicated by an arrow 60.

FIGS. 9B and 10B illustrate a second operating position of the stopcockof FIG. 1, which is typically employed for drawing blood or other fluidsfrom the patient. The user typically connects a syringe (not shown) toport 16 and draws blood from the patient through port 14 and partiallyperipherally-extending recess 52 through port 16 to the syringe, asindicated by an arrow 62. It is appreciated that this operating positionmay also be used for supplying a medicament to the patient when port 18is closed, in a flow direction opposite to that indicated by arrow 62.

FIGS. 9C and 10C illustrate a third operating position of the stopcockof FIG. 1, which is typically employed for supplying a medicament to thepatient when port 16 is open or connected to a secondary line (notshown). A secondary line may be a source of medicament. The medicamentflows through port 16 and partially peripherally-extending recess 52through port 14 to the patient, as indicated by an arrow 63. At the sametime, liquid flows via port 18 and partially peripherally-extendingrecess 52, around fluid flow guide 54, and slightly into the internalvolume 25 of port 16, via port 14 to the patient, as indicated by anarrow 64.

FIGS. 9D and 10D illustrate a fourth operating position of the stopcockof FIG. 1, which is typically employed for supplying a liquid to thepatient from port 18 to port 14, when port 16 is sealed as by threadedplug 23. Liquid flows via port 18 and partially peripherally-extendingrecess 52, around fluid flow guide 54, and into the internal volume 25of port 16, flushing residual liquid therefrom, via port 14 to thepatient, as indicated by an arrow 66.

It is a particular feature of the present invention that the provisionof fluid flow guide 54 generally overcomes problems of the presence ofresidual liquids remaining in the internal volume 25 of port 16. This isimportant in various therapeutic situations. For example when blood isdrawn from the patient through port 16, there remains residual blood inthe internal volume 25 of port 16. This blood, if left in internalvolume 25 for a period of time, can clot and thus become dangerous ifdelivered to the patient. In addition, the coagulated blood couldocclude the liquid passageway extending through port 16. Variousinfections could possibly arise as a result of the retained blood.

This feature is also useful when a medicament is supplied to a patientthrough port 16. If a portion of the medicament remains in the internalvolume 25 of port 16, the dosage of the medicament that the patientreceives is less than the intended dosage by an amount which cannot bereadily ascertained. In addition, this residual medicament might beinadvertently supplied to the patient during a subsequent use of thestopcock, which could cause harm to the patient.

The present invention provides for automatic flushing of the liquid,such as blood or medicament, from the internal volume 25 and typicallyreturning it to the patient without requiring the use of extra syringes,the manipulation of the threaded plug 23 and opening the medical set tothe atmosphere, which could increase the chance of contamination.

FIGS. 9E and 10E illustrate a fifth operating position of the stopcockof FIG. 1, which may be used for flushing the IV set upstream of thestopcock, when port 16 is open to the atmosphere. Liquid flows via port18, around fluid flow guide 54 and through partiallyperipherally-extending recess 52, to the atmosphere via port 16, asindicated by an arrow 68. Alternatively, this operating position may beemployed for pushing liquid via the side port 16 and through port 18 ina direction opposite arrow 68, for example when it is desired to mixliquid in the pressure bag.

Reference is now made to FIG. 11, which is an exploded view illustrationof a stopcock constructed and operative in accordance with a preferredembodiment of the present invention. As seen in FIG. 11, the stopcockcomprises a housing element 110 including a main tubular portion 112 andthree side ports, designated by reference numerals 114, 116 and 118respectively. A handle element 120 is arranged to be seated 10, withinmain tubular portion 112 of housing element 110.

Reference is now made additionally to FIGS. 12 and 13 which arepictorial illustrations of housing element 110 and to FIGS. 14A and 14Bwhich are sectional illustrations thereof. As seen in FIGS. 11-14B,tubular portion 112 of housing element 110 is generally cylindrical,arranged about an axis 122, and has side ports 114, 116 and 118extending in different directions therefrom, typically separated by 90degrees about axis 122. Port 114 is preferably a male port whichpreferably meets luer standard ISO 594-1, while port 116 incorporates anormally closed swabbable valve which is configured to receive a maleluer and port 118 is preferably a female port, which preferably meetsluer standard ISO 594-1. Conventional plugs, nuts and covers may be usedin association with ports 114 and 118.

Port 116 of housing element 110 includes a valve employing anelastomeric element 123, held in place by a cap 124, which is welded orotherwise fixed to housing element 110. Elastomeric element 123 and cap124 are commercially available from Halkey-Roberts Corporation of St.Petersburg, Fla., USA and described in one or more of U.S. Pat. Nos.6,651,956; 6,089,541 and 6,036,171, the disclosures of which are herebyincorporated by reference. Alternatively, valves and valve elementscommercially available from other sources such as Becton-Dickinson,Cardinal, Medegen and Filtertek may be employed.

Tubular portion 112 includes a central bore 125 having a slightlyconical configuration, which is formed with a circumferential undercut126. Port 116 defines an internal volume 127.

Reference is now made to FIGS. 15A-18B, which illustrate handle element120. As seen in FIGS. 15A-18B, the handle element includes a shaftportion 130, which is integrally formed with a top portion 132 fromwhich extends a finger-engageable protrusion 134. It is appreciated thatany other suitable general configuration of the top portion of thehandle element may alternatively be employed.

Shaft portion 130 is generally symmetrical about a shaft axis 142 andhas a slightly conical outer surface 144, typically having an angle α(as seen particularly in FIG. 16A) of 3-4 degrees, which corresponds tothe slightly conical configuration of central bore 125 for rotatablesealing engagement therewith. As seen particularly in FIGS. 18A and 18B,shaft portion 130 is typically formed with mutually sealed top andbottom cylindrical recesses 146 and 148, which are sealingly separatedby a divider 150.

Disposed generally between recesses 146 and 148 and sealed therefrom isa partially peripherally-extending recess 152, selectably defining afluid flow passageway between selectable ones of side ports 114, 116 and118 depending on the rotational orientation of the handle element 120relative to the housing element 110. Preferably extending radially andpartially bifurcating the recess 152 is a fluid flow guide 154, whichdirects the flow of liquid between ports 114 and 118 through thepassageway defined by recess 152 into the internal volume 127 of port116 for flushing thereof, when the handle element 120 is suitablypositioned. The radially outward facing edge 156 of fluid flow guide 154is formed with a concave configuration.

Reference is now made to FIGS. 19A, 19B, 19C and 19D, which aresimplified pictorial illustrations of the stopcock of FIG. 11 in fouroperative orientations and to FIGS. 20A, 20B, 20C and 20D, which aresectional illustrations of the stopcock of FIGS. 19A, 19B, 19C and 19D,respectively.

FIGS. 19A and 20A illustrate a first operating position of the stopcockof FIG. 11. The user typically connects a source of pressurized fluid,such as an IV set, to port 118 and the liquid flows through port 118 andpartially peripherally-extending recess 152 and past the concave edge156 of fluid flow guide 154 via port 114 to the patient, as indicated byan arrow 160.

FIGS. 19B and 20B illustrate a second operating position of the stopcockof FIG. 11, which is typically employed for drawing blood or otherfluids from the patient. The user typically connects a syringe to port116 and draws blood from the patient through port 114 and partiallyperipherally-extending recess 152 through port 116 to the syringe, asindicated by an arrow 162. It is appreciated that this operatingposition may also be used for supplying a medicament to the patient whenport 118 is closed, in a flow direction opposite to that indicated byarrow 162.

FIGS. 19C and 20C illustrate a third operating position of the stopcockof FIG. 11, which is typically employed for supplying a liquid to thepatient from port 118 to port 114. Liquid flows via port 118 andpartially peripherally-extending recess 152, around fluid flow guide154, and into the internal volume 127 of port 116 as well as an internalvolume 166 of the elastomeric element 123, flushing residual liquidtherefrom, via port 114 to the patient, as indicated by an arrow 164.

It is a particular feature of the present invention that the provisionof fluid flow guide 154 generally overcomes problems of the presence ofresidual liquids remaining in the internal volume 127 of port 116 aswell as in internal volume 166 of the elastomeric element 123. This isimportant in various therapeutic situations. For example when blood isdrawn from the patient through port 116, there remains residual blood inthe internal volumes 127 of port 116 and 166 of elastomeric element 123.This blood, if left in internal volumes 127 and 166 for a period oftime, can clot and thus become dangerous if delivered to the patient. Inaddition, the coagulated blood could occlude the liquid passagewayextending through port 116. Various infections could possibly arise as aresult of the retained blood.

This feature is also useful when a medicament is supplied to a patientthrough port 116. If a portion of the medicament remains in the internalvolumes 127 of port 116 and 166 of the elastomeric element 123, thedosage of the medicament that the patient receives is less than theintended dosage by an amount which cannot be readily ascertained. Inaddition, this residual medicament might be inadvertently supplied tothe patient during a subsequent use of the stopcock, which could causeharm to the patient.

The present invention provides for automatic flushing of the liquid,such as blood or medicament, from the internal volumes 127 and 166 andtypically returning it to the patient without requiring the use of extrasyringes and the opening of the medical set to the atmosphere, therebyincreasing the chance of contamination.

FIGS. 19D and 20D illustrate a fourth operating position of the stopcockof FIG. 11, which may be used for flushing the IV set upstream of thestopcock, when port 116 is open to the atmosphere as by insertion of amale luer connector, such as a syringe tip (not shown), into theelastomeric element 123 of the valve thereof. The insertion of the maleluer connector activates the flow of liquid from port 118, around fluidflow guide 154 and through partially peripherally-extending recess 152,to the male luer connector via the elastomeric element 123 of port 116,as indicated by an arrow 165. Alternatively, this operating position maybe employed for pushing liquid via the side port 116 and through port118 in a direction opposite arrow 165, for example when it is desired tomix liquid in the pressure bag.

Reference is now made to FIG. 21, which is an exploded view illustrationof a stopcock constructed and operative in accordance with a preferredembodiment of the present invention. As seen in FIG. 21, the stopcockcomprises a housing element 210 including a main tubular portion 212 andthree side ports, designated by reference numerals 214, 216 and 218respectively. A handle element 220 is arranged to be seated within maintubular portion 212 of housing element 210.

Reference is now made additionally to FIGS. 22 and 23 which arepictorial illustrations of housing element 210 and to FIGS. 24A and 24Bwhich are sectional illustrations thereof. As seen in FIGS. 21-24B,tubular portion 212 of housing element 210 is generally cylindrical,arranged about an axis 222, and has side ports 214, 216 and 218extending in different directions therefrom, typically separated by 90degrees about axis 222. Port 214 is preferably a male port whichpreferably meets luer standard ISO 594-1, while port 216 incorporates anormally closed swabbable valve which is configured to receive a maleluer and port 218 is preferably a female port, which preferably meetsluer standard ISO 594-1. Conventional plugs, nuts and covers may be usedin association with ports 214 and 218.

Port 216 of housing element 210 includes a valve employing anelastomeric element 223, held in place by a cap 224, which is welded orotherwise fixed to housing element 110. Elastomeric element 123 and cap124 are commercially available from Halkey-Roberts Corporation of St.Petersburg, Fla., USA and described in one or more of U.S. Pat. Nos.6,651,956; 6,089,541 and 6,036,171, the disclosures of which are herebyincorporated by reference. Alternatively, valves and valve elementscommercially available from other sources such as Becton-Dickinson,Cardinal, Medegen and Filtertek may be employed.

Tubular portion 212 includes a central bore 225 having a slightlyconical configuration, which is formed with a circumferential undercut226. Port 216 defines an internal volume 227.

Reference is now made to FIGS. 25A-28B, which illustrate handle element220. As seen in FIGS. 25A-28B, the handle element includes a shaftportion 230, which is integrally formed with a top portion 232 fromwhich extends a finger-engageable protrusion 234. It is appreciated thatany other suitable general configuration of the top portion of thehandle element may alternatively be employed.

Shaft portion 230 is generally symmetrical about a shaft axis 242 andhas a slightly conical outer surface 244, typically having an angle a(as seen particularly in FIG. 26A) of 3-4 degrees, which corresponds tothe slightly conical configuration of central bore 225 for rotatablesealing engagement therewith. As seen particularly in FIGS. 28A and 28B,shaft portion 230 is typically formed with mutually sealed top andbottom cylindrical recesses 246 and 248, which are sealingly separatedby a divider 250.

Disposed generally between recesses 246 and 248 and sealed therefrom isa partially peripherally-extending recess 252, selectably defining afluid flow passageway between selectable ones of side ports 214, 216 and218 depending on the rotational orientation of the handle element 220relative to the housing element 210. Preferably extending radially andpartially bifurcating the recess 252 is a fluid flow guide 254, whichdirects the flow of liquid between ports 214 and 218 through thepassageway defined by recess 252 into the internal volume 227 of port216 for flushing thereof, when the handle element 220 is suitablypositioned. The radially outward facing edge 256 of fluid flow guide 254is formed with a suitably tapered configuration in order to preventliquid flow therepast when fluid flow guide 254 is not located oppositea port.

Reference is now made to FIGS. 29A, 29B, 29C and 29D, which aresimplified pictorial illustrations of the stopcock of FIG. 21 in fouroperative orientations and to FIGS. 30A, 30B, 30C and 30D, which aresectional illustrations of the stopcock of FIGS. 29A, 29B, 29C and 29D,respectively.

FIGS. 29A and 30A illustrate a first operating position of the stopcockof FIG. 21. As seen, there is no fluid communication between any of theports. Liquid does not flow from port 218 to port 214, because it isblocked by fluid flow guide 254, whose edge 256 sealingly engages aninner facing wall 257 of bore 225 of housing element 210. Thisorientation may be utilized to close all three ports.

The operative orientation shown in FIGS. 29A and 30A may beadvantageously employed when it is desired to prevent all flow of liquidthrough the stopcock. The procedure currently used requires carefulplacement of the handle to an angle 45 degrees from one of the ports.Such a procedure is unreliable and requires careful attention of theoperator, which may be a doctor or a nurse in the middle of a surgery.

FIGS. 29B and 30B illustrate a second operating position of the stopcockof FIG. 21, which is typically employed for drawing blood or otherfluids from the patient. The user typically connects a syringe to port216 and draws blood from the patient through port 214 and partiallyperipherally-extending recess 252 through port 216 to the syringe, asindicated by an arrow 262. It is appreciated that this operatingposition may also be used for supplying a medicament to the patient whenport 218 is closed, in a flow direction opposite to that indicated byarrow 262.

FIGS. 29C and 30C illustrate a third operating position of the stopcockof FIG. 21, which is typically employed for supplying a liquid to thepatient from port 218 to port 214. Liquid flows via port 218 andpartially peripherally-extending recess 252, around fluid flow guide254, and into the internal volume 227 of port 216 as well as an internalvolume 266 of the elastomeric element 223, flushing residual liquidtherefrom, via port 214 to the patient, as indicated by an arrow 264.

It is a particular feature of the present invention that the provisionof fluid flow guide 254 generally overcomes problems of the presence ofresidual liquids remaining in the internal volume 227 of port 216 aswell as in internal volume 266 of the elastomeric element 223. This isimportant in various therapeutic situations. For example when blood isdrawn from the patient through port 216, there remains residual blood inthe internal volumes 227 of port 216 and 266 of the elastomeric element223. This blood, if left in internal volumes 227 and 266 for a period oftime, can clot and thus become dangerous if delivered to the patient. Inaddition, the coagulated blood could occlude the liquid passagewayextending through port 216. Various infections could possibly arise as aresult of the retained blood.

This feature is also useful when a medicament is supplied to a patientthrough port 216. If a portion of the medicament remains in the internalvolumes 227 of port 216 and 266 of the elastomeric element 223, thedosage of the medicament that the patient receives is less than theintended dosage by an amount which cannot be readily ascertained. Inaddition, this residual medicament might be inadvertently supplied tothe patient during a subsequent use of the stopcock, which could causeharm to the patient.

The present invention provides for automatic flushing of the liquid,such as blood or medicament from the internal volumes 227 and 266 andtypically returning it to the patient without requiring the use of extrasyringes and the opening of the medical set to the atmosphere, therebyincreasing the chance of contamination.

FIGS. 29D and 30D illustrate a fourth operating position of the stopcockof FIG. 21, which may be used for flushing the IV set upstream of thestopcock, when port 216 is open to the atmosphere as by insertion of amale luer connector, such as a syringe tip (not shown), into theelastomeric element 223 of the valve thereof. The insertion of the maleluer connector activates the flow of liquid from port 218, around fluidflow guide 254 and through partially peripherally-extending recess 252,to the male luer connector via the elastomeric element 223 of port 216,as indicated by an arrow 265. Alternatively, this operating position maybe employed for pushing liquid via the side port 216, through port 218,in a direction opposite arrow 265 for uses such as mixing liquid in thepressure bag.

Reference is now made to FIG. 31, which is an exploded view illustrationof a stopcock constructed and operative in accordance with a preferredembodiment of the present invention. As seen in FIG. 31, the stopcockcomprises a housing element 310 including a main tubular portion 312 andthree side ports, designated by reference numerals 314, 316 and 318respectively. A handle element 320 is arranged to be seated within maintubular portion 312 of housing element 310.

Reference is now made additionally to FIGS. 32 and 33 which arepictorial illustrations of housing element 310 and to FIGS. 34A and 34Bwhich are sectional illustrations thereof. As seen in FIGS. 31-34B,tubular portion 812 of housing element 310 is generally cylindrical,arranged about an axis 322, and has side ports 314, 316 and 318extending indifferent directions therefrom, typically separated by 90degrees about axis 322. Port 314 is preferably a male port whichpreferably meets luer standard ISO 594-1, while port 316 incorporates anormally closed swabbable valve which is configured to receive a maleluer and port 318 is preferably a female port, which preferably meetsluer standard ISO 594-1. Conventional plugs, nuts and covers may be usedin association with ports 314 and 318.

Port 316 of housing element 310 includes a valve employing anelastomeric element 323 held in place by a cap 324, which is welded orotherwise fixed to housing element 310. Elastomeric element 323 and cap324 are commercially available from Halkey-Roberts Corporation of St.Petersburg, Fla., USA and described in one or more of U.S. Pat. Nos.6,651,956; 6,089,541 and 6,036,171, the disclosures of which are herebyincorporated by reference. Alternatively valves and valve elementscommercially available from other sources such as Becton-Dickinson,Cardinal, Medegen and Filtertek may be employed.

Tubular portion 312 includes a central bore 325 having a slightlyconical configuration, which is formed with a circumferential undercut326. In this embodiment, a side recess 327 is formed in a wall of bore325 opposite port 316. Port 316 defines an internal volume 328.

Reference is now made to FIGS. 35A-38B, which illustrate handle element320. As seen in FIGS. 35A-38B, the handle element includes a shaftportion 330, which is integrally formed with a top portion 332 fromwhich extends a finger-engageable protrusion 334. It is appreciated thatany other suitable general configuration of the top portion of thehandle element may alternatively be employed.

Shaft portion 330 is generally symmetrical about a shaft axis 342 andhas a slightly conical outer surface 344, typically having an angle α(as seen particularly in FIG. 36A) of 3-4 degrees, which corresponds tothe slightly conical configuration of central bore 325 for rotatablesealing engagement therewith. As seen particularly in FIGS. 38A and 38B,shaft portion 330 is typically formed with mutually sealed top andbottom cylindrical recesses 346 and 348, which are sealingly separatedby a divider 350.

Disposed generally between recesses 346 and 348 and sealed therefrom isa partially peripherally-extending recess 352. Preferably extendingradially and partially bifurcating the recess 352 is a fluid flow guide354, which directs the flow of liquid between ports 314 and 318 throughthe passageway defined by recess 352 into the internal volume 328 ofport 316 for flushing thereof, when the handle element 320 is suitablypositioned. The thickness of fluid flow guide 354 is substantially lessthan the circumferential extent of side recess 327. The radially outwardfacing edge 356 of fluid flow guide 354 is formed with a suitablytapered configuration in order to prevent liquid flow therepast whenfluid flow guide 354 is not located opposite a port.

Reference is now made to FIGS. 39A, 39B, 39C and 39D, which aresimplified pictorial illustrations of the stopcock of FIG. 31 in fouroperative orientations and to FIGS. 40A, 40B, 40C and 40D, which aresectional illustrations of the stopcock of FIGS. 39A, 39B, 39C and 39D,respectively.

FIGS. 39A and 40A illustrate a first operating position of the stopcockof FIG. 31. The user typically connects a source of pressurized fluid,such as an IV set, to port 318 and the liquid flows from port 318,around fluid flow guide 354, through side recess 327 to port 314, asindicated by arrow 360.

FIGS. 39B and 40B illustrate a second operating position of the stopcockof FIG. 31, which is typically employed for drawing blood or otherfluids from the patient. The user typically connects a syringe to port316 and draws blood from the patient through port 314 and partiallyperipherally-extending recess 352 through port 316 to the syringe, asindicated by an arrow 362. It is appreciated that this operatingposition may also be used for supplying a medicament to the patient whenport 318 is closed, in a flow direction opposite to that indicated byarrow 362.

FIGS. 39C and 40C illustrate a third operating position of the stopcockof FIG. 31, which is typically employed for supplying a liquid to thepatient from port 318 to port 314. Liquid flows via port 318 andpartially peripherally-extending recess 352, around fluid flow guide354, and into the internal volume 328 of port 316 as well as an internalvolume 366 of the elastomeric element 323, flushing residual liquidtherefrom, via port 314 to the patient, as indicated by an arrow 364.

It is a particular feature of the present invention that the provisionof fluid flow guide 354 generally overcomes problems of the presence ofresidual liquids remaining in the internal volume 328 of port 316 aswell as in internal volume 366 of the elastomeric element 323. This isimportant in various therapeutic situations. For example when blood isdrawn from the patient through port 316, there remains residual blood inthe internal volume 328 of port 316 and the internal volume 366 of theelastomeric element 323. This blood, if left in internal volumes 328 and366 for a period of time, can clot and thus become dangerous ifdelivered to the patient. In addition, the coagulated blood couldocclude the liquid passageway extending through port 316. Variousinfections could possibly arise as a result of the retained blood.

This feature is also useful when a medicament is supplied to a patientthrough port 316. If a portion of the medicament remains in the internalvolumes 328 of port 316 and 366 of the elastomeric element 323, thedosage of the medicament that the patient receives is less than theintended dosage by an amount which cannot be readily ascertained. Inaddition, this residual medicament might be inadvertently supplied tothe patient during a subsequent use of the stopcock, which could causeharm to the patient.

The present invention provides for automatic flushing of the liquid,such as blood or medicament, from the internal volumes 328 and 366 andtypically returning it to the patient without requiring the use of extrasyringes and the opening of the medical set to the atmosphere, therebyincreasing the chance of contamination.

FIGS. 39D and 40D illustrate a fourth operating position of the stopcockof FIG. 31, which may be used for flushing the IV set upstream of thestopcock, when port 316 is open to the atmosphere as by insertion of amale luer connector, such as a syringe tip (not shown), into theelastomeric element 323 of the valve thereof. The insertion of the maleluer connector activates the flow of liquid from port 318, around fluidflow guide 354 and through partially peripherally-extending recess 352,to the male luer connector via the elastomeric element 323 of port 316,as indicated by an arrow 365. Alternatively, this operating position maybe employed for pushing liquid via the side port 316, through port 318,in a direction opposite arrow 365, for uses such as mixing liquid in thepressure bag.

Reference is now made to FIG. 41, which is an exploded view illustrationof a stopcock constructed and operative in accordance with a preferredembodiment of the present invention. As seen in FIG. 41, the stopcockcomprises a housing element 410 including a main tubular portion 412 andthree side ports, designated by reference numerals 414, 416 and 418respectively. A handle element 420 is arranged to be seated within maintubular portion 412 of housing element 410.

Reference is now made additionally to FIGS. 42 and 43 which arepictorial illustrations of housing element 410 and to FIGS. 44A and 44Bwhich are sectional illustrations thereof. As seen in FIGS. 41-44B,tubular portion 412 of housing element 410 is generally cylindrical,arranged about an axis 422, and has side ports 414, 416 and 418extending in different directions therefrom, typically separated by 90degrees about axis 422. Port 414 is preferably a male port whichpreferably meets luer standard ISO 594-1, while port 416 incorporates anormally closed swabbable valve which is configured to receive a maleluer and port 418 is preferably a female port, which preferably meetsluer standard ISO 594-1. Conventional plugs, nuts and covers may be usedin association with ports 414 and 418.

Port 416 of housing element 410 includes a valve employing anelastomeric element 423, held in place by a cap 424, which is welded orotherwise fixed to housing element 410. Elastomeric element 423 and cap424 are commercially available from Halkey-Roberts Corporation of St.Petersburg, Fla., USA and described in one or more of U.S. Pat. Nos.6,651,956; 6,089,541 and 6,036,171, the disclosures of which are herebyincorporated by reference. Alternatively, valves and valve elementscommercially available from other sources such as Becton-Dickinson,Cardinal, Medegen and Filtertek may be employed.

Tubular portion 412 includes a central bore 425 having a slightlyconical configuration, which is formed with a circumferential undercut426. Port 416 defines an internal volume 427.

Reference is now made to FIGS. 45A-48B, which illustrate handle element420. As seen in FIGS. 45A-48B, the handle element includes a shaftportion 430, which is integrally formed with a top portion 432 fromwhich extends a finger-engageable protrusion 434. It is appreciated thatany other suitable general configuration of the top portion of thehandle element may alternatively be employed.

Shaft portion 430 is generally symmetrical about a shaft axis 442 andhas a slightly conical outer surface 444, typically having an angle a(as seen particularly in FIG. 46A) of 3-4 degrees, which corresponds tothe slightly conical configuration of central bore 425 for rotatablesealing engagement therewith. As seen particularly in FIGS. 48A and 48B,shaft portion 430 is typically formed with mutually sealed top andbottom cylindrical recesses 446 and 448, which are sealingly separatedby a divider 450.

Disposed generally between recesses 446 and 448 and sealed therefrom isa side-to-side extending bore 452 and a side bore 453 extendingperpendicularly with respect thereto and communicating therewith. Bore452 and side bore 453 are bifurcated by a fluid flow guide 454 in such amanner that fluid communication between opposite ends of bore 452 takesplace via side bore 453. Bores 452 and 453 and fluid flow guide 454define a fluid flow passageway between selectable ones of side ports414, 416 and 418 depending on the rotational orientation of the handleelement 420 relative to the housing element 410. Fluid flow guide 454directs the flow of liquid between ports 414 and 418 through bores 452and 453 into the internal volume 427 of port 416 for flushing thereof,when the handle element 420 is suitably positioned. The radially outwardfacing edge 456 of fluid flow guide 454 is formed with a suitablytapered configuration in order to prevent liquid flow therepast whenfluid flow guide 454 is not located opposite a port as shown in FIG.45A, alternatively it may have many other shapes.

Reference is now made to FIGS. 49A, 49B, 49C and 49D, which aresimplified pictorial illustrations of the stopcock of FIG. 41 in fouroperative orientations and to FIGS. 50A, 50B, 50C and 50D, which aresectional illustrations of the stopcock of FIGS. 49A, 49B, 49C and 49D,respectively.

FIGS. 49A and 50A illustrate a first operating position of the stopcockof FIG. 41. As seen, there is no fluid communication between any of theports. Liquid does not flow from port 418 to port 414, because it isblocked by fluid flow guide 454, whose edge 456 sealingly engages aninner facing wall 457 of central bore 425 of housing element 410. Thisorientation may be utilized to close all three ports.

The operative orientation shown in FIGS. 49A and 50A may beadvantageously employed when it is desired to prevent all flow of liquidthrough the stopcock. The procedure currently used requires carefulplacement of the handle to an angle 45 degrees from one of the ports.Such a procedure is unreliable and requires careful attention of theoperator, which may be a doctor or a nurse in the middle of a surgery.

FIGS. 49B and 50B illustrate a second operating position of the stopcockof FIG. 41, which is typically employed for drawing blood or otherfluids from the patient. The user typically connects a syringe to port416 and draws blood from the patient through port 414 and bores 453 and452 through port 416 to the syringe, as indicated by an arrow 462. It isappreciated that this operating position may also be used for supplyinga medicament to the patient when port 418 is closed, in a flow directionopposite to that indicated by arrow 462.

FIGS. 49C and 50C illustrate a third operating position of the stopcockof FIG. 41, which is typically employed for supplying a liquid to thepatient from port 418 to port 414. Liquid flows via port 418 and bores452 and 453, around fluid flow guide 454, and into the internal volume427 of port 416 as well as an internal volume 466 of the elastomericelement 423, flushing residual liquid therefrom, via port 414 to thepatient, as indicated by an arrow 464.

It is a particular feature of the present invention that the provisionof fluid flow guide 454 generally overcomes problems of the presence ofresidual liquids remaining in the internal volume 427 of port 416 aswell as in internal volume 466 of the elastomeric element 423. This isimportant in various therapeutic situations. For example when blood isdrawn from the patient through port 416, there remains residual blood inthe internal volume 427 of port 416 and the internal volume 466 of theelastomeric element 423. This blood, if left in internal volumes 427 and466 for a period of time, can clot and thus become dangerous ifdelivered to the patient. In addition, the coagulated blood couldocclude the liquid passageway extending through port 416. Variousinfections could possibly arise as a result of the retained blood.

This feature is also useful when a medicament is supplied to a patientthrough port 416. If a portion of the medicament remains in the internalvolumes 427 of port 416 and 466 of the elastomeric element 423, thedosage of the medicament that the patient receives is less than theintended dosage by an amount which cannot be readily ascertained. Inaddition, this residual medicament might be inadvertently supplied tothe patient during a subsequent use of the stopcock, which could causeharm to the patient.

The present invention provides for automatic flushing of the liquid,such as blood or medicament from the internal volumes 427 and 466 andtypically returning it to the patient without requiring the use of extrasyringes and the opening of the medical set to the atmosphere, therebyincreasing the chance of contamination.

FIGS. 49D and 50D illustrate a fourth operating position of the stopcockof FIG. 41, which may be used for flushing the IV set upstream of thestopcock, when port 416 is open to the atmosphere as by insertion of amale luer connector, such as a syringe tip (not shown), into theelastomeric element 423 of the valve thereof. The insertion of the maleluer connector activates the flow of liquid from port 418, around fluidflow guide 454 and through bores 453 and 452, to the male luer connectorvia the elastomeric element 423 of port 416, as indicated by an arrow465. Alternatively, this operating position may be employed for pushingliquid via the side port 416, through port 418, in a direction oppositearrow 465, for uses such as mixing liquid in the pressure bag.

Reference is now made to FIG. 51, which is an exploded view illustrationof a stopcock constructed and operative in accordance with a preferredembodiment of the present invention. As seen in FIG. 51, the stopcockcomprises a housing element 510 including a main tubular portion 512 andthree side ports, designated by reference numerals 514, 516 and 518respectively. A handle element 520 is arranged to be seated within maintubular portion 512 of housing element 510.

Reference is now made additionally to FIGS. 52 and 53 which arepictorial illustrations of housing element 510 and to FIGS. 54A and 54Bwhich are sectional illustrations thereof. As seen in FIGS. 51-54B,tubular portion 512 of housing element 510 is generally cylindrical,arranged about an axis 522, and has side ports 514, 516 and 518extending in different directions therefrom, typically separated by 90degrees about axis 522. Port 514 is preferably a male port whichpreferably meets luer standard ISO 594-1, while port 516 incorporates anormally closed swabbable valve which is configured to receive a maleluer and port 518 is preferably a female port, which preferably meetsluer standard ISO 594-1. Conventional plugs, nuts and covers may be usedin association with ports 514 and 518.

Port 516 of housing element 510 includes a valve employing anelastomeric element 523, held in place by a cap 524, which is welded orotherwise fixed to housing element 510. Elastomeric element 523 and cap524 are commercially available from Halkey-Roberts Corporation of St.Petersburg, Fla., USA and described in one or more of U.S. Pat. Nos.6,651,956; 6,089,541 and 6,036,171, the disclosures of which are herebyincorporated by reference. Alternatively, valves and valve elementscommercially available from other sources such as Becton-Dickinson,Cardinal, Medegen and Filtertek may be employed.

Tubular portion 512 includes a central bore 525 having a slightlyconical configuration, which is formed with a circumferential undercut526. Between bore 525 and elastomeric element 523, port 516 isbifurcated by a fluid flow guide 527. Port 516 defines an internalvolume 528.

Reference is now made to FIGS. 55A-58B, which illustrate handle element520. As seen in FIGS. 55A-58B, the handle element includes a shaftportion 530, which is integrally formed with a top portion 532 fromwhich extends a finger-engageable protrusion 534. It is appreciated thatany other suitable general configuration of the top portion of thehandle element may alternatively be employed.

Shaft portion 530 is generally symmetrical about a shaft axis 542 andhas a slightly conical outer surface 544, typically having an angle α(as seen particularly in FIG. 56A) of 3-4 degrees, which corresponds tothe slightly conical configuration of central bore 525 for rotatablesealing engagement therewith. As seen particularly in FIGS. 58A and 58B,shaft portion 530 is typically formed with mutually sealed top andbottom cylindrical recesses 546 and 548, which are sealingly separatedby a divider 550.

Disposed generally between recesses 546 and 548 and sealed therefrom isa partially peripherally-extending recess 552, selectably defining afluid flow passageway between selectable ones of side ports 514, 516 and518 depending on the rotational orientation of the handle element 520relative to the housing element 510. Preferably extending radially andpartially bifurcating the recess 552 is a fluid flow guide 554, whichdirects the flow of liquid between ports 514 and 518 through thepassageway defined by recess 552 into the internal volume 528 of port516 for flushing thereof, when the handle element 520 is suitablypositioned. The radially outward facing edge 556 of fluid flow guide 554is formed with a suitably tapered configuration in order to preventliquid flow therepast when fluid flow guide 554 is not located oppositea port as shown in FIG. 55A, alternatively it may have many othershapes.

Reference is now made to FIGS. 59A, 59B, 59C and 59D, which aresimplified pictorial illustrations of the stopcock of FIG. 51 in fouroperative orientations and to FIGS. 60A, 60B, 60C and 60D, which aresectional illustrations of the stopcock of FIGS. 59A, 59B, 59C and 59D,respectively.

FIGS. 59A and 60A illustrate a first operating position of the stopcockof FIG. 51. As seen, there is no fluid communication between any of theports. Liquid does not flow from port 518 to port 514, because it isblocked by fluid flow guide 554, whose edge 556 sealingly engages aninner facing wall 557 of bore 525 of housing element 510. Thisorientation may be utilized to close all three ports.

The operative orientation shown in FIGS. 59A and 60A may beadvantageously employed when it is desired to prevent all flow of liquidthrough the stopcock. The procedure currently used requires carefulplacement of the handle to an angle 45 degrees from one of the ports.Such a procedure is unreliable and requires careful attention of theoperator, which may be a doctor or a nurse in the middle of a surgery.

FIGS. 59B and 60B illustrate a second operating position of the stopcockof FIG. 51, which is typically employed for drawing blood or otherfluids from the patient. The user typically connects a syringe to port516 and draws blood from the patient through port 514 and partiallyperipherally-extending recess 552 through port 516 to the syringe, asindicated by an arrow 562. It is appreciated that this operatingposition may also be used for supplying a medicament to the patient whenport 518 is closed, in a flow direction opposite to that indicated byarrow 562.

FIGS. 59C and 60C illustrate a third operating position of the stopcockof FIG. 51, which is typically employed for supplying a liquid to thepatient from port 518 to port 514. Liquid flows via port 518 andpartially peripherally-extending recess 552, along fluid flow guides 554and 527, and into the internal volume 528 of port 516 as well as aninternal volume 566 of the elastomeric element 523, flushing residualliquid therefrom, via port 514 to the patient, as indicated by an arrow564.

It is a particular feature of the present invention that the provisionof fluid flow guides 554 and 527 generally overcomes problems of thepresence of residual liquids remaining in the internal volume 528 ofport 516 as well as in internal volume 566 of the elastomeric element523. This is important in various therapeutic situations. For examplewhen blood is drawn from the patient through port 516, there remainsresidual blood in the internal volume 528 of port 516 and the internalvolume 566 of the elastomeric element 523. This blood, if left ininternal volumes 528 and 566 for a period of time, can clot and thusbecome dangerous if delivered to the patient. In addition, thecoagulated blood could occlude the liquid passageway extending throughport 516. Various infections could possibly arise as a result of theretained blood.

This feature is also useful when a medicament is supplied to a patientthrough port 516. If a portion of the medicament remains in the internalvolumes 528 of port 516 and 566 of the elastomeric element 523, thedosage of the medicament that the patient receives is less than theintended dosage by an amount which cannot be readily ascertained. Inaddition, this residual medicament might be inadvertently supplied tothe patient during a subsequent use of the stopcock, which could causeharm to the patient.

The present invention provides for automatic flushing of the liquid,such as blood or medicament from the internal volumes 528 and 566 andtypically returning it to the patient without requiring the use of extrasyringes and the opening of the medical set to the atmosphere, therebyincreasing the chance of contamination.

FIGS. 59D and 60D illustrate a fourth operating position of the stopcockof FIG. 51, which may be used for flushing the IV set upstream of thestopcock, when port 516 is open to the atmosphere as by insertion of amale luer connector, such as a syringe tip (not shown), into theelastomeric element 523 of the valve thereof. The insertion of the maleluer connector activates the flow of liquid from port 518, around fluidflow guide 554 and through partially peripherally-extending recess 552,to the male luer connector via the elastomeric element 523 of port 516,as indicated by an arrow 565. Alternatively, this operating position maybe employed for pushing liquid via the side port 516, through port 518,in a direction opposite arrow 565, for uses such as mixing liquid in thepressure bag.

Reference is now made to FIGS. 61A, 61B and 61C, which are simplifiedpictorial illustrations of an arterial monitoring set constructed andoperative in accordance with a preferred embodiment of the presentinvention in various operative orientations. The arterial monitoring setincludes a fluid-filled bag 612 and a tube portion 614 leading to apatient's artery. An arterial pressure sensor 616, which isschematically depicted in drawings 61A-61C, is coupled in a series alongtube portion 614 and provides a visible output on a conventional monitor618. Downstream of arterial pressure sensor 616 there is provided astopcock 620 of the type described hereinabove with reference to any ofFIGS. 11-60D, including a swabbable valve 622 having an elastomericelement 623.

FIG. 61A shows the stopcock in an operative orientation such as thatshown in FIGS. 19A and 20A, FIGS. 29A and 30A, FIGS. 39A and 40A, FIGS.49A and 50A and FIGS. 59A and 60A. As shown in FIGS. 19A, 20A, 39A and40A, a liquid passes through the arterial set, including stopcock 620;from the bag 612 to the artery of the patient. Alternatively, as shownin the stopcocks illustrated in FIGS. 29A, 30A, 49A, 50A, 59A and 60A,this operative orientation may be utilized when a medical procedurerequires a cessation of the flow of liquid in the arterial set.

FIG. 61B shows the stopcock in an operative orientation such as thatshown in FIGS. 19B and 20B, FIGS. 29B and 30B, FIGS. 39B and 40B, FIGS.49B and 50B and FIGS. 59B and 60B, which is typically employed fordrawing blood or other fluids from the patient, by employing a syringe624 coupled to the swabbable valve 622. It is appreciated that thisoperating position may also be used for supplying medicament to thepatient via syringe 624.

FIG. 61C shows the stopcock in an operative orientation such as thatshown, for example in FIGS. 19C and 20C, FIGS. 29C and 30C, FIGS. 39Cand 40C, FIGS. 49C and 50C and FIGS. 59C and 60C, which is typicallyemployed for supplying a liquid to the patient from the arterial set.Liquid flows through the stopcock and flushes the internal volume of theswabbable valve and of the port in which it is located, flushingresidual liquid therefrom to the patient.

Because it enables an operator to easily draw blood without exposing thearterial line to the atmosphere, use of a stopcock shown in any of FIGS.11-60D in a monitoring set reduces both the risk of contamination andthe need for extra covers or plugs.

For routine use in arterial lines, the stopcock is employed in aposition such as that shown in FIGS. 19A, 20A, 39A, 40A and 61A, wherethe fluid flows from the arterial line to the patient without makingcontact with the elastomeric element 623 of the valve 622.

To draw blood from the patient, the operator places the handle of thestopcock in the operative orientation shown in FIGS. 19B, 20B, 29B, 30B,39B, 40B, 49B, 50B, 59B, 60B and 61B, introduces a syringe to the valve,thereby opening it, and draws blood.

After blood is drawn, residual blood remains in the internal volumes ofthe valve and the side port of the stopcock. This residual blood, if notremoved from the stopcock, may cause damage to the patient as discussedhereinabove with reference to drawings 9C, 19C, 20C, 29C, 30C, 39C, 40C,49C, 50C, 59C and 60C.

In order to clear the residual blood from the internal volumes, theoperator places the handle of the stopcock in the operative orientationshown in FIGS. 19C, 20C, 29C, 30C, 39C, 40C, 49C, 50C, 59C, 60C and 61C.In this orientation, the flow of liquid in the arterial line flushes theinternal volumes of both the valve and the side port of the stopcock andclears the residual blood therefrom.

For use of the stopcock in monitoring the arterial blood pressure of thepatient, the flow of liquid must not come in contact with theelastomeric component of the valve. Therefore, when the operator hasremoved the residual blood from the internal volumes of the valve andthe side port of the stopcock, he would again place the handle of thestopcock in the operative orientation seen in FIG. 61A.

It is appreciated that the stopcock structure shown and describedhereinabove may have many advantageous uses in addition to thosedescribed specifically hereinabove.

It will be appreciated by persons skilled in the art that the presentinvention is not limited to what has been particularly shown anddescribed hereinabove. Rather the scope of the present inventionincludes both combinations and subcombinations of the various featuresdescribed hereinabove as well as modifications and variations thereof aswould occur to a person of skill in the art upon reading the foregoingspecification and which are not in the prior art.

The invention claimed is:
 1. A stopcock comprising: a housing elementdefining a central bore and at least first, second and third ports; ahandle element which is selectably positionable relative to said housingelement; at least one fluid passageway communicating between at leasttwo of said at least first, second and third ports, said at least onefluid passageway being selectably defined by rotational positioning ofsaid handle element relative to said housing element; a first fluid flowguide associated with said at least one fluid flow passageway, saidfirst fluid flow guide extending radially and sealingly engaging aninner facing wall of said central bore when said first fluid flow guideis not located opposite at least one of said first, second and thirdports; and a second fluid flow guide bifurcating said at least one fluidpassageway, said first flow guide and said second fluid flow guide beingconfigured for enabling flushing an internal volume of at least one ofsaid first, second and third ports by a fluid flow which does not flowentirely through said port whose internal volume is being flushed.
 2. Astopcock according to claim 1 and also comprising a valve located withinone of the at least one of first, second and third ports.
 3. A stopcockaccording to claim 2 and wherein said valve has an open first end and anormally closed second end.
 4. A stopcock according to claim 2 andwherein said at least one fluid passageway is configured for enablingflushing an internal volume of said valve.
 5. A stopcock according toclaim 1 and wherein said at least one fluid passageway is defined by atleast one recess formed on a peripheral surface of said handle element.6. A stopcock according to claim 5 and wherein said at least one recessis partially bifurcated by said first fluid flow guide.
 7. A stopcockaccording to claim 1 and wherein said first fluid flow guide comprisesan outward facing edge adapted to prevent a flow of liquid when saidfirst fluid flow guide is not located opposite said at least one of saidports.
 8. A stopcock according to claim 1 and wherein said handleelement and said housing element are arrangeable in multiple mutualpositions.
 9. A stopcock according to claim 8 and wherein said firstfluid flow guide and said at least one fluid passageway are configuredfor enabling flushing an internal volume of at least one of said first,second and third ports by a fluid flow which does not flow entirelythrough said port whose internal volume is being flushed, when saidhousing element and said handle element are in at least one of saidmultiple mutual positions.